Individual
MIRA FRADKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
913 W WELLINGTON AVE FL 3, CHICAGO, IL 60657-6709
(872) 843-0300
Mailing address
913 W WELLINGTON AVE FL 3, CHICAGO, IL 60657-6709
(872) 843-0300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.113813
IL
Other
Enumeration date
08/14/2024
Last updated
02/25/2026
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